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Open-heart surgery in premature and low-birth-weight infants--a single-centre experience
Evelyn Lechner1, Gabriele Wiesinger-Eidenberger, Martin Weissensteiner
1Department of Neonatology, Children's and Maternity Hospital Linz, Krankenhausstrasse 26-30, 4020 Linz, Austria. elechner@aon.at
Objective:
Because of their poor clinical status, infants may require surgery for congenital heart disease regardless of weight or prematurity. This retrospective review describes a single-centre experience with open-heart surgery in low-weight infants.
Methods:
From November 1997 to December 2006, 411 open-heart surgery procedures were performed in neonates. This included 46 consecutive infants weighing less than 2500 g, who underwent cardiopulmonary bypass for correction of congenital heart defects (n=34) or Norwood stage I palliation of hypoplastic left heart syndrome (HLHS) (n=12). In the low-weight group were 23 males and 23 females with a median age of 10 days and a median weight of 2.26 kg (range: 1.28-2.49 kg).
Results:
Early mortality was 8.2% in patients weighing more than 2.5 kg and 13% in the low-weight group. Within the low-weight group, weight at surgery, history of prematurity and prevalence of additional extracardiac malformations did not influence early mortality. At a median follow-up time of 32 months overall mortality was 21%. Thirty-four patients had a neurological follow-up examination 30 months postoperatively. Of the 34 survivors, 11 showed neurological deficits.
Conclusions:
In our patient population, early mortality was higher for infants weighing less than 2.5 kg. However, within the low-weight group, lower weight at surgery or history of prematurity was not associated with a higher mortality or bad neurological outcome.